Fluvoxamine in the treatment of obsessive compulsive disorder

Obsessive compulsive disorder is a chronic, often severe condition that is associated with considerable long term morbidity and suffering. Potent serotonin reuptake inhibitors are now regarded as first line treatments and their efficacy has been established in a series of placebo-controlled studies. The first of these compounds to become available, clomipramine, has undesirable effects on a number of other receptor systems and is associated with marked anticholinergic side effects. Of the selective serotonin reuptake inhibitors fluvoxamine is the most widely studied, with three small positive placebo-controlled and two recent large multicentre studies. These two studies show that fluvoxamine is associated with significant improvement on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the National Institute of Mental Health Obsessive Compulsive Scale (NIMH-OC) and the Global Improvement item of the Clinical Global Impression (CGImp) Scale, compared with placebo.